Institute for Traditional Medicine Practitioner Reference Guide January 2016 Below, you will find valuable background information for our listing of practitioners in the U.S. who utilize Chinese medicine and prescribe herbs as a significant part of their practice. The list is limited; we provide methods for finding many additional practitioners and provide suggestions for contacting them.
Chinese Medicine in the U.S. Chinese medicine is a licensed health profession in the U.S. The scope of practice usually involves acupuncture and associated physical therapies plus herb prescribing. As of 2007, in the U.S. there are:
about 16,000 licensed acupuncturists in practice. about 10,000 acupuncturists prescribe Chinese herbs regularly;
about 5,000 medical doctors who practice acupuncture under their medical license, but most do not prescribe Chinese herbs;
about 2,500 other health professionals, mainly naturopathic physicians, chiropractors, massage therapists, registered nurses, and nutritionists who prescribe Chinese herbs, but usually do not perform acupuncture.
More than one-third of the licensed acupuncturists completed their basic training in Chinese medicine within the last eight years; most of the others received their training some time between 1978 and 1998. The majority of practitioners of Chinese medicine live in just nine states: California, Washington, Oregon, New Mexico, Colorado, Texas, New York, Massachusetts, and Florida; and most of them live in and around major cities. To find a practitioner of Chinese medicine is not always easy, because there are so few at this time (about one for every 20,000 Americans). Acupuncturists are the professional group with the most members trained in the use of Chinese herbs. If a local practitioner is not found in this ITM listing, here are some methods you might pursue to find others in your area:
Ask people you know in order to get a personal recommendation.
Look in the yellow pages of your phone directory (or that of the nearest major city) for acupuncturists, for physicians–naturopathic, or similar headings for the other types of practitioners.
Contact a state professional association (e.g., for acupuncturists, the association is often designated by the state name followed by Acupuncture Association) or a local college of Oriental Medicine or Naturopathic Medicine.
The American Association of Oriental Medicine (AAOM) offers referrals to acupuncturists nationally; they have a website for searching: http://www.acufinder.com/
The National Commission for the Certification of Acupuncture (NCCA) provides diplomas in acupuncture and in Chinese herbs prescribing; they maintain a listing of diplomates, with a searchable web page: http://dol.jkmcomm.com/acupuncture/default.asp
Once you have the name of a practitioner, especially if the individual is not on the ITM listing, you will need to call and determine whether or not they have experience suitable for the method of therapy you desire. It is assumed that if you are seeking a practitioner via ITM’s listing, a central interest in getting Chinese herbal therapies along the lines of those described in the articles posted on the ITM website.
Our Listing of Practitioners To get onto our list, practitioners must fill out and submit a questionnaire we have prepared to become an ITM member, and their information is reviewed to see if their practice is sufficiently similar in nature to what is offered at the ITM clinics in Portland to additionally have them listed here. The practitioners listed here are licensed or certified in one or more health professions, have at least 3 years clinical experience (average is 12 years) including current prescribing of Chinese herbs, and have access to ITM educational materials (for example, are familiar with our website presentations of articles and know about or have ITM publications). A record of their training and granted degrees as well as their medical specialties is retained at the ITM offices. These practitioners do not pay for their listing in the guide (this is not an advertisement for their practices). In many cases, there are other skilled health professionals working in the same clinic along with the practitioners who are listed here: we usually only list one name per clinic. Some of the practitioners work in more than one office, dividing their practice among certain days, thus servicing a larger region. ITM has direct communication with about 1,000 practitioners, but sufficient data to list only about 500 of them as meeting our criteria. This guide is revised regularly to add names as they qualify; we also request updated information from practitioners every three years and remove names of those who do not respond and those who are participating in alternative medicine practices that are not approved. Within each state, the names are listed by city (city names are alphabetically ordered). Failure to appear in the listing does not necessarily mean that a practitioner did not meet the above-mentioned criteria. Acupuncturists are designated by: C.A. (certified acupuncturist), L.Ac. (licensed acupuncturist), D.Ac. (diplomate of acupuncture; the practitioner passed the NCCA exam), R.Ac. (registered acupuncturist), A.P. (acupuncture physician), or O.M.D. (Oriental medical doctor; sometimes D.O.M., doctor of Oriental medicine). Generally, listing of several of these acupuncture titles does not imply more training than if there is only one title listed. Those who were trained initially in Western medicine are designated M.D. (medical doctor), N.D. (naturopathic doctor), D.O. (doctor of osteopathy), R.N. (registered nurse), Pharm.D. (pharmacist), or D.C. (doctor of chiropractic); a few practitioners are licensed or certified massage therapists (L.M.T. or C.M.T.). If an individual has received a Ph.D., that is also listed, but undergraduate degrees, obtained by many of the practitioners, and master’s degrees, are not indicated.
Specialists It is important to recognize that a practitioner need not have previously treated individuals with your particular health problem in the past in order to be able to apply natural therapies successfully for your unique case. This is because Chinese medicine is complementary medicine; its application is aimed at optimizing health according to the constitution and symptoms of the individual. It is intended to be used in addition to any therapies that are recommended by a specialist working with standard modern medical techniques. Natural therapies tend to produce non-specific solutions, such as enhancing the body’s response to disease, rather than specific solutions, such as directly destroying a pathogenic organism, altering genetic expression, or eliminating all traces of cancer cells. Therefore, the common question: “How much experience do you have treating this particular disease,” may not be revealing of the Chinese medical practitioner’s ability to provide assistance. Although most people with serious diseases would like to see a specialist, there are very few specialists in the field of Chinese medicine in the U.S. ITM provides information (such as that posted on our website) about methods used in China for treating several specific diseases, such as neurological disorders, various types of cancer, hepatitis B and C, and degenerative conditions. It is difficult to predict the outcome of using Chinese medicine for any individual patient. Clinical studies have been conducted in China that reveal a certain level of effectiveness, but the responses can range from slight improvements to remarkable improvements, and the results will depend on numerous factors, some of which remain unknown. The quality of study design and reporting from China is often poor, so that reliable claims for effectiveness can not be made on the basis of the study reports. Therefore, your own response to treatments must be a primary guide to deciding whether to continue them.
What to Do When You Call If you decide to call a practitioner’s office to arrange a consultation, it is usually not expected (or desired) that you describe your health history or health problems—this is reserved for the time when you meet with the practitioner. However, you may inquire about the practitioner’s range of therapeutic techniques, and about any special areas of interest the practitioner may have pursued (many practitioners now offer their own websites to provide such information). It is also recommended that you check to determine whether the practitioner has focused his or her studies and practice on a particular field, such as traditional Chinese medicine (TCM), or is involved with a wide variety of “alternative medicine” practices. Generally, practitioners who employ methods far removed from the scope of practice for their license will not have the desired expertise in their licensed field. Examples of alternatives to watch for are: electronic testing devices, muscle testing, trade-marked treatment techniques, and a variety of non-standard laboratory tests (tests that your medical doctor would not order for you). Also be careful of practitioners who claim to treat you with acupuncture but utilize, instead of needles, tuning forks, crystals, colored lights, or other such methods of “energetically stimulating” the points. When you call, check on office fees and time required for the first appointment. As a basis for comparison, the cost of a standard return office visit (typical duration of about 30–40 minutes) to the listed practitioners is usually in the range of $45–$95 (U.S. average is $60), not including any prescribed supplements. Initial visits, which take longer (typical duration is 45–90 minutes) have a higher cost, usually 50% higher than the return visits. It is common for medical doctors and naturopathic physicians to have higher fees than acupuncturists, massage therapists, and chiropractors. Some practitioners offer discounts to those with verifiable financial need, and many practitioners can bill insurers for those services covered by insurance (but insurance coverage may be limited). You must check with your insurer to find out if your policy covers the services of the provider you are going to visit. Herb prescriptions typically have a cost of about $3/day, though this can vary with particular needs. Generally, the fees for herbs and nutritional supplements are not covered by medical insurance policies.
It is only after a first meeting with the practitioner that it is possible to determine a course of therapy, including estimates of the number and frequency of visits, the types of therapeutic methods that might be necessary, the likely costs involved, and what outcome would be reasonably expected in the short run if the therapy is successful. As a general guideline, for serious chronic diseases, expect to undertake treatment for a minimum of 3–6 months, with some positive results noted within the first few weeks (each treatment can provide obvious benefits, but to change the course of a serious disorder usually takes time). For some pain syndromes, as few as 1–3 office visits over a period of one or two weeks might suffice. Whether or not the method will be of some help to you should be evident within a few visits for acupuncture or other physical therapy (as a general rule, after 5-6 treatments for acupuncture), and within 4–6 weeks for herb therapy alone, even if the total course of therapy will be longer. Discuss any concerns you have about your progress with the practitioner.
What to Do in Areas Where There are No Practitioners In the event that there are no practitioners nearby, you might travel some distance to have an initial consultation with a practitioner. For herbal therapy, it is possible that after an initial meeting you may receive additional consultations by phone and herb supplies by mail. In the case of serious ailments, if you can visit a friend or relative in a major city for a couple of weeks and get regular treatments during that time, it may be sufficient to get the therapeutic process under way, allowing long distance follow-up. If visiting a practitioner is not an option, there are some nutritional therapies (e.g., vitamins, minerals, and other substances) that you might obtain for yourself. This can be accomplished by relying on products marketed nationwide, selected after studying the literature on the disease condition and carefully following the published recommendations. However, this approach should not substitute for seeking direct medical care whenever that is possible. Many products sold in stores or via the internet (or other routes) contain little of the desired active components in the recommended dosage, so beware.
Institute for Traditional Medicine (ITM) ITM provides educational materials to practitioners of traditional Chinese medicine. These materials are mainly in the form of articles and books that further the basic education of practitioners and provide details about the current practices in China (and results obtained in clinical trials). ITM promotes the concept of fully integrating traditional Chinese medicine and Western medicine to attain the maximum benefits for persons seeking better health. Practitioners refer to ITM literature to enhance the training they already have gained.
Complaints, Concerns and Recommendations In providing this practitioner reference guide, ITM is not making a referral to one of the practitioners; rather, ITM is making available additional information to aid in your search for professional medical assistance and passing on details that we have gathered from the practitioners about their licensing, years in practice, and access to ITM literature. If you have a complaint or concern regarding a visit to a listed practitioner, please write down the details and mail to ITM, 2017 SE Hawthorne, Portland, Oregon 97214 or contact us via email. We may be able to investigate the situation and provide a response. It is hoped and expected that you will find the practitioners listed here provide excellent services and we would like to be apprised of any failings. If you are very pleased with a visit to a listed practitioner, you may wish to recommend their services to others in your community and you may want to send a note to ITM expressing your favorable response. If you have a concern about a specific treatment or a product that has been prescribed, ask the practitioner first, and then, if you cannot obtain a satisfactory answer, you may contact ITM by email about the matter.
About the Safety of Chinese Herbs In general, Chinese herbs are safe to use, but it is wise to take certain precautions. Always follow the instructions of the practitioner who prescribes the herbs, and inform that practitioner promptly if you believe you have experienced any adverse effect from taking them. If you are also taking drugs, make sure you inform your doctor that you are taking herbs and inform your herb prescriber about the specific drugs you are taking. Very little is currently known about herb-drug interactions; in the Orient, combining herbs and drugs is a common practice and thought to present few problems (an article about checking for herb-drug interactions is linked from the home page of the ITM website). Any person may have an allergy or an idiosyncratic (unexpected, individualistic) reaction to any herb. Such reactions are quite rare, but they can be serious. If you notice an allergy-type reaction (usually a skin rash that appears within three days of starting to take the herbs), cease using the herbs and contact your practitioner. If you are taking herbs for an extended period of time (several months), make sure you have routine medical check-ups including standard blood testing, just as would be done with long-term drug use.
About the Frequency of Acupuncture Therapy In China, it is common for acupuncturists to treat patients on a daily or every other day basis over the course of a week or two (sometimes longer) in order to make substantial and lasting changes in the condition being treated. By comparison, in America, it is more common for acupuncturists to treat patients only once per week. However, depending upon the severity of the ailment, on how long the effects of acupuncture are maintained after each treatment, and other factors, it may be advisable to more closely follow the Chinese model. The results of 6 or 8 treatments over two weeks may be superior to the same number of treatments spread over two months, while having the same cost and total office visit time. It is important for patients to inform their practitioners about how long the beneficial effects of a treatment lasted. If they only lasted two days, then treatment every two or three days may be needed in order to make sufficient progress. In the event that only infrequent treatment is possible, then greater reliance may need to be placed on herb therapies, diet changes, special exercises, and methods of treatment that can be performed at home between office visits.